Provider Demographics
NPI:1457688707
Name:LORUSSO, CARMELINA (MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:CARMELINA
Middle Name:
Last Name:LORUSSO
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-2328
Mailing Address - Country:US
Mailing Address - Phone:413-773-0494
Mailing Address - Fax:
Practice Address - Street 1:904 MOHAWK TRL
Practice Address - Street 2:
Practice Address - City:SHELBURNE FALLS
Practice Address - State:MA
Practice Address - Zip Code:01370-9705
Practice Address - Country:US
Practice Address - Phone:413-625-2305
Practice Address - Fax:413-625-8422
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10265751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical